Main Causes Of Ill Health In Construction

There have been big improvements over recent years in reducing the number and rate of injuries to construction workers. Despite this, construction remains a high-risk industry and accounts for a high percentage of fatal and major injuries.

What is less recognised is that construction is a high-risk industry for health issues too. Below are some key points about these risks, why they are so significant and how to manage them.

Ill Health In Numbers

Every year more working days are lost due to work-related illness compared to injuries. The statistics (PDF) reveals that construction workers have a high risk of developing diseases from a number of health issues.

• Cancer – construction has the largest burden of occupational cancer amongst the industrial sectors. It accounts for over 40% of occupational cancer deaths and cancer registrations. It is estimated that past exposures in the construction sector annually cause over 5,000 occupational cancer cases and approximately 3,700 deaths.  The most significant cause of these cancers is asbestos (70%) followed by silica (17%) working as a painter and diesel engine exhaust (6-7% each).
• Hazardous substances – dusts, chemicals and potentially harmful mixtures (eg in paints) are common in construction work. Some processes emit dusts, fumes, vapours or gases into the air and these can be significant causes of breathing problems and lung diseases. A number of construction-related occupations also have high rates of dermatitis from skin exposures to hazardous substances.
• Physical health risks – skilled construction and building trades are one of the occupations with the highest estimated prevalence of back injuries and upper limb disorders. Manual handling is the most commonly reported cause of over seven day injuries in the industry. Construction also has one of highest rates of ill health caused by noise and vibration.

Underlying causes

There are many reasons why construction workers have a high risk of developing occupational disease. This includes:

• The construction site environment – unlike a factory, construction work takes place in many and varied environments. Different sites can present a range of health risks, including existing ones like asbestos. The extent of these risks can also vary between areas of the same site.
• The dynamic nature of the work – construction sites are constantly changing and a large number of trades may all be carrying out tasks potentially dangerous to their health and that of others.
• Risk appreciation – there is generally a low awareness of health risks and the controls needed. It can take many years for serious ill health conditions to develop  and the immediate consequence of a harmful workplace exposure may often be dismissed as not significant compared to the immediate impact of injuries caused by accidents.
• Employment – many workers are either self-employed, work for small companies, or frequently change employers. Others work away from home. These situations can make it problematical for workers to easily look after their own health and they often have little or no contact with occupational health professionals.

74,000 workers suffering from work-related ill health (new or long-standing) averaged over the three-year period 2018/19-2020/21 

Prior to the coronavirus pandemic, the rate of self-reported work-related ill health had been broadly flat. In 2020/21 the rate was not statistically significantly different to the 2018/19 pre-coronavirus level.

Common Principles

The risks of ill health can be managed by following the simple steps outlined in the rest of this website. These steps follow a few essential common principles:

• ‘Ill-health can be prevented’ – it is possible and practical to carry out construction work without causing ill-health.
• ‘Treat health like safety’ – managing health risks is no different to managing safety risks. Follow the Assess, Control, Review steps.
• ‘Everyone has a role to play’ – everyone involved in construction has a responsibility in managing risks to health. Each must take ownership of their part of the process.
• ‘Control the risk, not the symptoms’ – monitoring and health surveillance programmes are not enough on their own. While they are an effective part of managing health risks, the first priority is to stop people being exposed to the risk in the first place.
• ‘Manage risk, not lifestyles’ – the law requires steps to be taken to prevent or adequately control work-related health risks. Helping workers tackle lifestyle issues like smoking or diet may be beneficial but is not a substitute for this.